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Rheumatology Advance Access published online on August 23, 2005
Rheumatology, doi:10.1093/rheumatology/kei085
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© The Author 2005. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For Permissions, please email: journals.permissions@oupjournals.org
Received July 1, 2005
Accepted July 19, 2005

Concise Report

Effectiveness of reducing infliximab dose interval in non-responder patients with refractory spondyloarthropathies. An open extension of a multicentre study

E. Collantes-Estevez 1*, M. C. Muñoz-Villanueva 1, P. Zarco 2, J. C. Torre-Alonso 3, J. Gratacós 4, C. González 5, R. Sanmartí 6, J. D. Cañete 6, and Spanish Spondyloarthropathies Study Group

1 Department of Rheumatology, Reina Sofia University Hospital of Córdoba, Córdoba, Spain
2 Department of Rheumatology, Fundación Hospital of Alcorcón, Madrid, Spain
3 Department of Rheumatology, Monte Naranco Hospital, Oviedo, Spain
4 Department of Rheumatology, Parc Taulí Hospital, Sabadell, Spain
5 Department of Rheumatology, Gregorio Marañón University Hospital, Madrid, Spain
6 Department of Rheumatology, Clinic Hospital of Barcelona, Barcelona, Spain

* To whom correspondence should be addressed.
E. Collantes-Estevez, E-mail: ecollantes{at}ctv.es


  Abstract

Objective. To evaluate the therapeutic effectiveness of reducing the infliximab dose interval to 6 weeks in spondyloarthropathy patients not responding to 5 mg/kg every 8 weeks.

Methods. After 30 weeks of infliximab therapy, 25 patients were classified as responders [Bath Ankylosing Spondylitis Activity Index (BASDAI) <4 cm or ESR <30 mm/h and CRP <5 mg/l, n=15; group A] or non-responders (patients who did not achieve the response established for group A; n=10; group B). Responders continued on 5 mg/kg every 8 weeks and non-responders decreased the dose interval to 6 weeks. BASDAI, Bath Ankylosing Spondylitis Functional Index (BASFI), ESR, CRP and ankylosing spondylitis assessment (ASAS) criteria were used to assess response.

Results. At 62 weeks, 11 of 15 patients (73.3%, 95% confidence interval=44.9-92.2%) from group A and three of 10 patients (30%, 95% confidence interval=6.7-65.2) from group B were responders (P=0.049). Eighty per cent (eight of 10 patients from group A) and 22.2% (two of 9 patients from group B) achieved 50% BASDAI improvement (P=0.023), and nine of 11 patients (81.8%) and four of 10 (40%) from groups A and B, respectively, reached ASAS20 at 62 weeks (P=0.08).

Conclusion. Patients on infliximab 5 mg/kg every 8 weeks with persistent disease activity may benefit from reducing the dose interval to 6 weeks.

Keywords: Ankylosing spondylitis; Spondyloarthropathies; Infliximab; Anti-tumour necrosis factor-{alpha}.
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